When we think of the impact of a spinal cord injury, we tend to focus on the significant limitations with the loss of mobility, but for a large share of people living with this injury, it’s actually the chronic pain which is one of the most challenging issues to manage long-term.
Neuropathic pain affects about 60 per cent of people with a spinal cord injury. It’s generally felt at or below the zone of injury and is often described as sharp, burning, unbearable and even terrifying.
It can lead to a range of challenges like depression, catastrophizing or panic thinking, poor sleep, social isolation and reduced physical activity.
Professor of Rehabilitation Ashley Craig said medications like antidepressants, antiepileptics and opioids are used to treat neuropathic pain, but they offer limited relief and come with a host of side effects.
“Most medications provide only a third of patients with up to a 30 per cent reduction in their pain, while other non-medication approaches have failed to have any real impact,” he said.
However, an exciting clinical trial will shortly get underway as a result of a $2.2 million grant through the Medical Research Future Fund.
The team from the Kolling Institute’s John Walsh Centre for Rehabilitation Research will work with national and international experts to investigate the impact of an innovative approach targeting pain pathways in the brain.
This new approach will combine direct brain stimulation with an advanced interactive brain-computer neuromodulation therapy.
Professor Craig said both these interventions are showing some promising results, and we are looking forward to measuring the impact of their combined approach.
“Our research will aim to confirm if these therapies will offer significant and consistent improvements in neuropathic pain for people living with a spinal cord injury," he said.
“Chronic pain after a spinal cord injury results in an altered cortical neurochemistry and blood flow resulting in cortical dysrhythmia.
“This is where brain neuromodulation therapy can really help. It involves a non-invasive approach to correcting the dysrhythmia and improving pain.
“Interactive brain computer therapy is an extension of established treatments, while direct brain stimulation is a well-tolerated form of non-invasive brain stimulation to promote brain plasticity.
“We are keen to test these approaches through the clinical trial and help provide evidenced based guidelines to relieve neuropathic pain and improve outcomes for those living with a chronic spinal cord injury.”
This clinical trial will also help researchers at the John Walsh Centre for Rehabilitation Research pursue other innovative psychological interventions to reduce catastrophizing thinking and subsequently neuropathic pain.